Ottawa Ankle Rules

Does this ankle injury require an x-ray?


The Ottawa ankle rules have been validated in adults with 100% Sensitivity.

In children ages 1-15 the Ottawa Ankle rules have been validated with 98-100% Specificity and 36-47% Sensitivity for clinically significant ankle injuries, however other studies have suggested lower sensitivity rates. Clinical judgment should be used in younger children.


Libetta et al.

Journal of Accident & Emergency Medicine 1999, 16 (5): 342-4

Plint et al.

Academic Emergency Medicine 1999, 6 (10): 1005-9

Stiell et al.

JAMA: the Journal of the American Medical Association 1993 March 3, 269 (9): 1127-32

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1. Inability to weight bear (4 steps) both immediately and in the Emergency department?

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